Shiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701Considering social accountability in rehabilitation therapy school939440993ENHAJAR SHIEHClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, IranMITRA AMINIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-3761-1801FATEMEH MIRClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, IranPARISA NABEIEIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, IranJAVAD KOJURIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8909-897XJournal Article20170625As you know, there is increasing attention insocial accountability concept for medicaland other health professional schools. Despite theuniqueness of the concept of social accountability,it has different definitions in various fields. TheWorld Health Organization (WHO) has describedsocial accountability generally as follows: “theobligation to direct education, research andservice activities toward addressing the priorityhealth concerns of community, region, ornation”(1). Applied to health professional schools,the idea of social accountability recognizes it’sprospective for transforming community byacting throughout the educational, researchand healthcare delivery, on a mixture of socialdeterminants of health factors and for helpingto make a proficient and equitable health system.One of the health professional schools inShiraz University of Medical Sciences is theSchool of Rehabilitation Therapy. This school iscommitted to lead and stimulate positive changesthat improve quality of lives through rehabilitationeducation, research and practice. As part of thiscommitment, the mission of this school is to teachoccupational therapists, physiotherapists andphysiotherapy scientists who contribute to wellbeingand welfare of the community. This schoolis recognized for excellent social accountability.In a qualitative study, we developed theindicators for assessing the concept of socialaccountability in this school based on the extensiveliterature review and expert opinions. Finally,57 indicators were determined for assessing thesocial accountability and used for assessment ofsocial accountability in this school (2).The results showed that considering thehealthcare needs of the community for educationand research, provision of interdisciplinaryeducation for students, addition of the idea ofsocial accountability in the accreditation system,teaching professionalism to students before theclinical courses, and cooperation with otherstakeholders (including academic health centers,physician communities, and other relevantparamedical schools) were reported as some of thestrengths of this school. Some of the weaknessesof this school were lack of continuous evaluationprograms for precise analysis of the currentneeds of the society and lack of correspondencebetween some of the elective training programswith the accountability approach. What’s more,the willingness of the community to participatein the health programs, lifestyle changes andchange in the public approval for services ineducational fields are some of the existing trendsin this school.It seems necessary that social accountabilityconcept of rehabilitation therapy schools shouldbe further taken into consideration as a meansof improving the outcomes of rehabilitationeducation, research and services.In conclusion, all health professional schools should contribute to the needs of society byeducating their students well in this field. Throughaccomplishment of these aims, these schools canplay the maximum effective role in the health ofthe community.Shiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701Evidence-based medicine in pre-clinical years: a study of early introduction and usefulness9510040994ENYOGESH ACHARYADepartment of Epidemiology and Preventive Medicine, Avalon University School of Medicine, Curacao, Netherlands0000-0003-1829-5911M.V. RAGHAVENDRA RAODepartment of Students’ Affairs, Avalon University School of Medicine, Curacao, NetherlandsSATEESH ARJADepartment of Administration, Avalon University School of Medicine, Curacao, NetherlandsJournal Article20170625Introduction: Evidence Based Medicine (EBM) has establisheditself as a strong predictor of future medical practice by medicalstudents. The purpose of this study was to determine theeffectiveness of EBM in pre-clinical years and reflect on selfassessmentskill of 4th semester medical students regarding theunderstanding of EBM and its various determinants.Methods: All of the 4th semester (MD4) medical students at theAvalon University of Medical School, Curacao who had completedtheir EBM curriculum were asked to voluntarily participatein a cross sectional student survey containing qualitative andquantitative questionnaires in a 10-point scale. The students’responses were analyzed statistically and the results reported.Results: Twenty-three students participated in the survey. 91%of them reported that EBM had helped them to better understandresearch process and 95% believed that EBM was necessary todevelop clinical skills in the future. 78% of the students agreedthat they were provided with enough resources for effectiveimplementation of EBM in the university. All participants(100%) self reported that they could appraise the research articleseffectively (mean score 8.26, S.D-1.45).Conclusions: EBM is an integrative and comprehensive way tosuccessfully adopt concepts of acquired medical knowledge foreffective medical practice. Early introduction of EBM in preclinicalyears proved favorable in students and better equipped them withthe ability to critically apprehend and appraise new research andinnovations in medicine for optimal learning experience. Thereis a definitive need for scientific and systematic design of thecurriculum for early introduction of EBM in pre-clinical years,best suited for the students. The principles should be directedtowards further research for the effective implementation of EBMto enhance clinical skills.Keywords: Evidence-based medicine; Medical education; Medical students; Curriculum; EvaluationShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701Evidence-based practice in Physiotherapy curricula: A survey of Indian Health Science Universities10110740996ENVRUSHALI P PANHALEDepartment of Musculoskeletal Sciences, MGM College of Physiotherapy, Kamothe, Navi Mumbai, IndiaBHARATI BELLAREDepartment of Musculoskeletal Sciences, MGM College of Physiotherapy, Kamothe, Navi Mumbai, IndiaMARIYA JIANDANIPhysiotherapy School &
Centre, Seth G S Medical College & KEM Hospital Parel, Mumbai, IndiaJournal Article20170625Introduction: Evidence-based practice (EBP) is the conscientious,explicit and judicious use of the current evidence in clinicaldecision making. The physiotherapy profession has expressed acommitment to the development and use of evidence. However,very little is known about the extent to which EBP is integrated inphysiotherapy curricula in India. The purpose of this study wasto describe integration of EBP in Indian physiotherapy programs.Methods: An observational study was conducted where a reviewof curricula of all Health Science Universities (HSU) in India,offering an undergraduate (UG) and post-graduate (PG) degreeprogram in physical therapy was conducted using a data abstractionsheet. It gathered data on inclusion of research components ofEBP in the curricula, content and hours of teaching EBP, andassessment methods. Data were analyzed descriptively.Results: Curricula of fifteen HSU offering physiotherapy programswere reviewed. Contents relevant to EBP were incorporatedfrom the 2nd yr to final year. Common courses included researchmethodology (84.61%), research project (69.23%) and clinicalmanagement subjects (57.14%). No guidelines were given aboutadopting EBP in clinical practice. Didactic lectures were the modeof teaching (81.81%). Preferred method for assessing researchprojects was viva (44.44%). Critical appraisal was least includedin the entry level education. Contents relevant to all the five stepsof EBP were included in PG curricula.Conclusions: Though physiotherapy programs are introducing EBPteaching at the entry level, it lacks structured systematic approachand is fragmented. There is inadequate emphasis on clinicaloriented teaching of EBP and assessment methods. Moreover, thereis adequate coverage of EBP content in PG curricula.Keywords: Evidence based practice; Physiotherapy; CurriculumShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701Social accountable medical education: a concept analysis10811540997ENMOHAMMADREZA ABDOLMALEKISchool of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, IranSHAHRAM YAZDANISchool of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-9193-7557SEDIGHEH MOMENISchool of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, IranNADER MOMTAZMANESHSchool of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20170625Introduction: Considering the pervasiveness of social accountablemedical education concept around the world and the growingtrend of literature in this regard as well as various interpretationsmade about this concept, we found it necessary to analyze theconcept of social accountable medical education.Methods: In this study, the modified version of McKenna’s approachto concept analysis was used to determine the concept, explainstructures and substructures and determine the border conceptsneighboring and against social accountability in medical education.Results: By studying the selected sources, the components ofthe concept were obtained to identify it and express an analyticdefinition of social accountability in medical education system.Then, a model case with all attributes of the given concept and thecontrary and related concepts were mentioned to determine theboundary between the main concept and auxiliary ones.Conclusion: According to the results of this study in the fieldof social accountability, the detailed and transparent analyticaldefinition of social accountable medical education can be used infuture studies as well as the function and evaluation of medicaleducation system.Keywords: Social accountability; Social responsibility; Social obligation; Medical educationShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701Self- directed learning barriers in a virtual environment: a qualitative study11612340998ENNOUSHIN KOHANDepartment of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IranKAMRAN SOLTANI ARABSHAHIDepartment of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran;0000-0002-9016-2593RITA MOJTAHEDZADEHDepartment of e-learning, Virtual School, Tehran University of Medical Sciences,Tehran, IranABBAS ABBASZADEHDepartment of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IranTAYEBEH RAKHSHANINutrition Research Center, Shiraz University of Medical Sciences, Shiraz, IranAMIRHOUSEIN EMAMIHematology and Oncology Department,
Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IranJournal Article20170625Introduction: There is a growing trend in online education coursesin higher education institutes. Previous studies have shown thathigh levels of self-direction are essential for successful onlinelearning. The present study aims to investigate challenges of andbarriers to self-directed virtual-learning among postgraduatestudents of medical sciences.Methods: 23 postgraduate virtual students of medical sciences inIran, collected through maximum variation purposive samplingand semi-structured interviews, served as the sample of thisstudy. The collected data were analyzed using the inductivecontent analysis method.Results: Three themes and six sub-themes were identified asbarriers to self-directed learning in virtual education, includingcognitive barriers (information overload and lack of focus onlearning or mind wondering), communication barriers (inadequatecoping skills and inadequate writing skills) and educationalenvironment barriers (heavy workload and role ambiguity).Conclusion: By the importance of self-direction in onlineeducation, the present study results can be used by virtualeducation planners in the review and design of courses, so as toadequately equip students, obviate barriers to self-directed virtualeducation, and ultimately train highly self-directed learners inonline medical education.Keywords: Medical education; Graduate medical education; Technology; LearningShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701Balancing power: A grounded theory study on partnership of academic service institutes12413340999ENFATEMEH HESHMATI NABAVINursing Management Department, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran;ZOHREH VANAKIDepartments of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranEESA MOHAMMADIDepartments of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranSHAHRAM YAZDANISchool of Medical Education
Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-9193-7557Journal Article20170625Introduction: Governments and professional organizationshave called for new partnerships between health care providersand academics to improve clinical education for the benefit ofboth students and patients. To develop a substantive groundedtheory on the process of forming academic-service partnershipsin implementing clinical education, from the perspective ofacademic and clinical nursing staff members and managersworking in Iranian settings.Methods: The participants included 15 hospital nurses, nursemanagers, nurse educators, and educational managers from twocentral universities and clinical settings from 2009 to 2012. Datawere collected through 30 in-depth, semi-structure interviewswith the individual participants and then analyzed using themethodology of Strauss and Corbin’s grounded theory.Results: Utilizing “balancing power” as the core variableenabled us to integrate the concepts concerning the partnershipprocesses between clinical and educational institutes. Threedistinct and significant categories emerged to explain the processof partnership: 1) divergence, 2) conflict between educational andcaring functions, and 3) creation of balance between educationaland caring functions.Conclusions: In implementing clinical education, partnerships havebeen formed within a challenging context in Iran. Conflict betweenclinical and educational functions was the main concern of bothsides of the partnership in forming a collaborative relationship, withour findings emphasizing the importance of nursing educators’ rolein the establishment of partnership programs.Keywords: Education; Nursing student, Power; Partnership practiceShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701A study on capabilities required in military medicine to develop modular training courses: a qualitative study13414741000ENALI DANA1Education Development Center, AJA University of Medical Sciences, Tehran, Iran, 2Department of Instructional Technology, Faculty of
Psychology and Education, Allameh Tabataba’i University, Tehran, IranMOJGAN MOHAMMADIMEHRDepartment of Microbiology, Education Development Center, AJA University of Medical Sciences, Tehran, Iran0000-0002-9210-0687Journal Article20170625Introduction: The main mission of military medicine in the worldis to support the health and treatment of the military in relationto issues, risks, injuries and diseases that arise due to the specificoccupational conditions. The current study was carried out withthe aim of determining the required skills of military physiciansto define and determine the required training modules.Methods: The study was a qualitative research. Semi-structuredinterviews were used to collect the data and qualitative contentanalysis was used to analyze the data. The study populationincluded all the professors and experts in the field of militarymedicine and medical sciences at the medical universities ofTehran. Snowball sampling technique was used to sample thestudy participants.Results: Based on the results, the required skills of militaryphysicians in 5 categories and 29 sub- categories were identified;then based on the identified skills, 60 training modules at twointroductory and advanced levels were determined including 39introductory levels and 21 advanced levels.Conclusion: We can conclude that some of the important skillsthat military physicians need and can achieved through traininghave not been provided in any educational program and to achievesuch skills and capabilities, other programs should be developedand modular training can be one of themKeywords: Medical education; Military medicine; Qualitative researchShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701Program evaluation of an integrated basic science medical curriculum in Shiraz Medical School, using CIPP evaluation model14815441001ENAZADEH ROOHOLAMINIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, IranMITRA AMINIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-3761-1801LEILA BAZRAFKANClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8191-4063MOHAMMAD REZADEHGHANIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, IranZOHREH ESMAEILZADEHClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, IranPARISA NABEIEIEClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, IranRITA REZAEEClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-9080-3629JAVAD KOJURIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8909-897XJournal Article20170625Introduction: In recent years curriculum reform and integrationwas done in many medical schools. The integrated curriculum isa popular concept all over the world. In Shiraz medical school,the reform was initiated by stablishing the horizontal basicscience integration model and Early Clinical Exposure (ECE)for undergraduate medical education. The purpose of this studywas to provide the required data for the program evaluation ofthis curriculum for undergraduate medical students, using CIPPprogram evaluation model.Methods: This study is an analytic descriptive and triangulationmixed method study which was carried out in Shiraz MedicalSchool in 2012, based on the views of professors of basic sciencescourses and first and second year medical students. The studyevaluated the quality of the relationship between basic sciencesand clinical courses and the method of presenting such coursesbased on the Context, Input, Process and Product (CIPP) model.The tools for collecting data, both quantitatively and qualitatively,were some questionnaires, content analysis of portfolios, semistructuredinterview and brain storming sessions. For quantitativedata analysis, SPSS software, version 14, was used.Results: In the context evaluation by modified DREEMquestionnaire, 77.75%of the students believed that this educationalsystem encourages them to actively participate in classes. Courseschedule and atmosphere of class were reported suitable by 87.81%and 83.86% of students. In input domain that was measured by aresearcher made questionnaire, the facilities for education wereacceptable except for shortage of cadavers. In process evaluation,the quality of integrated modules presentation and Early ClinicalExposure (ECE) was good from the students’ viewpoint. Inproduct evaluation, students’ brain storming, students’ portfolioand semi-structured interview with faculties were done, showingsome positive aspects of integration and some areas that needimprovement.Conclusion: The main advantage of assessing an educationalprogram based on CIPP evaluation model is that the context, input,process and product of the program are viewed and evaluatedsystematically. This will help the educational authorities to makeproper decisions based on the weaknesses and strengths of theprogram on its continuation, cessation and revision. Based on the results of this study, the integrated basic sciences course forundergraduate medical students in Shiraz Medical School isat a desirable level. However, attempts to improve or reformsome sections and continual evaluation of the program and itsaccreditation seem to be necessary.Keywords: Integration; Medical students; Basic science; CurriculumShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism5320170701The effect of gender bias on medical students and career choices: a cross-sectional study15515540995ENAKANKSHA GARGImperial College London, South Kensington Campus, Exhibition Road, London, SW7 2AZ, UKANURADHA BHIDEImperial College London, South Kensington Campus, Exhibition Road, London, SW7 2AZ, UKJournal Article20170724Gender equality amongst healthcareprofessionals is no doubt paramount to allowboth equal opportunity and provision of goodquality healthcare. The General Medical Councilencourages that all colleagues should be treatedfairly, but studies have previously demonstratedgender bias against female medical students(1). Whether this might have any impact on thestudents’ decision-making process and careerpathways has yet to be explored.We aimed to evaluate whether doctors gavestudents gender-specific advice and the extentto which this advice influenced the students.Furthermore, we explored whether students felttheir gender affected their career choices. Wecarried out a cross-sectional national study ofBritish clinical medical students. A standardisedquestionnaire was completed by 94 students(54.3% female). The response rate was 88.7%.Results showed that 43.6% (n=41) of studentsreceived career advice based purely on theirgender, and 63.4% (n=26) of these said that thiswould influence their career choices. Importantly,82.9% (n=34) of the students who receivedgender-specific advice were female.Additionally, 41.2% (n=21) of females felttheir gender would restrict their career choicescompared with only 11.6% (n=5) of males(p=0.00142). 37.3% (n=19) of females thoughttheir gender would unfairly disadvantage theircareer progression compared to 4.65% (n=2) ofmales (p=0.00016).Our results highlighted that doctors gave moregender-specific advice to females compared tomales, and that this advice significantly impactsstudents’ decision making process. Furthermore,females disproportionately felt their careers wouldbe disadvantaged and restricted compared withmales. This shows an enormous disparity betweenmale and female attitudes towards medical careers.This can have both long and short-term effects ontraining, career choices and patient interaction.Further research investigating why females feeltheir gender will restrict their careers, and whydoctors give gender-specific advice, particularlytargeted at females must be undertaken to identifythe root cause of the problem.We therefore advocate that medical schools: 1)promote gender equality through seminars, talksand increase accessibility to good female rolemodels; and 2) train clinical teachers to impartgeneric career advice as opposed to genderspecificcareer advice.